Dietary sugars and body weight: systematic review and meta-analyses of randomised controlled trials and cohort studies
Identifieur interne : 001682 ( Istex/Corpus ); précédent : 001681; suivant : 001683Dietary sugars and body weight: systematic review and meta-analyses of randomised controlled trials and cohort studies
Auteurs : Lisa Te Morenga ; Simonette Mallard ; Jim MannSource :
- BMJ : British Medical Journal [ 1756-1833 ] ; 2013.
Abstract
Objective To summarise evidence on the association between intake of dietary sugars and body weight in adults and children. Design Systematic review and meta-analysis of randomised controlled trials and prospective cohort studies. Data sources OVID Medline, Embase, PubMed, Cumulative Index to Nursing and Allied Health Literature, Scopus, and Web of Science (up to December 2011). Review methods Eligible studies reported the intake of total sugars, intake of a component of total sugars, or intake of sugar containing foods or beverages; and at least one measure of body fatness. Minimum duration was two weeks for trials and one year for cohort studies. Trials of weight loss or confounded by additional medical or lifestyle interventions were excluded. Study selection, assessment, validity, data extraction, and analysis were undertaken as specified by the Cochrane Collaboration and the GRADE working group. For trials, we pooled data for weight change using inverse variance models with random effects. We pooled cohort study data where possible to estimate effect sizes, expressed as odds ratios for risk of obesity or β coefficients for change in adiposity per unit of intake. Results 30 of 7895 trials and 38 of 9445 cohort studies were eligible. In trials of adults with ad libitum diets (that is, with no strict control of food intake), reduced intake of dietary sugars was associated with a decrease in body weight (0.80 kg, 95% confidence interval 0.39 to 1.21; P<0.001); increased sugars intake was associated with a comparable weight increase (0.75 kg, 0.30 to 1.19; P=0.001). Isoenergetic exchange of dietary sugars with other carbohydrates showed no change in body weight (0.04 kg, −0.04 to 0.13). Trials in children, which involved recommendations to reduce intake of sugar sweetened foods and beverages, had low participant compliance to dietary advice; these trials showed no overall change in body weight. However, in relation to intakes of sugar sweetened beverages after one year follow-up in prospective studies, the odds ratio for being overweight or obese increased was 1.55 (1.32 to 1.82) among groups with the highest intake compared with those with the lowest intake. Despite significant heterogeneity in one meta-analysis and potential bias in some trials, sensitivity analyses showed that the trends were consistent and associations remained after these studies were excluded. Conclusions Among free living people involving ad libitum diets, intake of free sugars or sugar sweetened beverages is a determinant of body weight. The change in body fatness that occurs with modifying intakes seems to be mediated via changes in energy intakes, since isoenergetic exchange of sugars with other carbohydrates was not associated with weight change.
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DOI: 10.1136/bmj.e7492
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<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title>Dietary sugars and body weight: systematic review and meta-analyses of randomised controlled trials and cohort studies</title><author><name sortKey="Te Morenga, Lisa" sort="Te Morenga, Lisa" uniqKey="Te Morenga L" first="Lisa" last="Te Morenga">Lisa Te Morenga</name><affiliation><mods:affiliation>Departments of Human Nutrition and Medicine, University of Otago, PO Box 56, Dunedin 9054, New Zealand</mods:affiliation></affiliation><affiliation><mods:affiliation>Riddet Institute, University of Otago</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: jim.mann@otago.ac.nz</mods:affiliation></affiliation></author><author><name sortKey="Mallard, Simonette" sort="Mallard, Simonette" uniqKey="Mallard S" first="Simonette" last="Mallard">Simonette Mallard</name><affiliation><mods:affiliation>Departments of Human Nutrition and Medicine, University of Otago, PO Box 56, Dunedin 9054, New Zealand</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: jim.mann@otago.ac.nz</mods:affiliation></affiliation></author><author><name sortKey="Mann, Jim" sort="Mann, Jim" uniqKey="Mann J" first="Jim" last="Mann">Jim Mann</name><affiliation><mods:affiliation>Departments of Human Nutrition and Medicine, University of Otago, PO Box 56, Dunedin 9054, New Zealand</mods:affiliation></affiliation><affiliation><mods:affiliation>Riddet Institute, University of Otago</mods:affiliation></affiliation><affiliation><mods:affiliation>Edgar National Centre for Diabetes and Obesity Research, University of Otago</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: jim.mann@otago.ac.nz</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: jim.mann@otago.ac.nz</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:0D94718C6A5DDD6D1657DEC11B3C362CFAF22C52</idno><date when="2013" year="2013">2013</date><idno type="doi">10.1136/bmj.e7492</idno><idno type="url">https://api.istex.fr/document/0D94718C6A5DDD6D1657DEC11B3C362CFAF22C52/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">001682</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a">Dietary sugars and body weight: systematic review and meta-analyses of randomised controlled trials and cohort studies</title><author><name sortKey="Te Morenga, Lisa" sort="Te Morenga, Lisa" uniqKey="Te Morenga L" first="Lisa" last="Te Morenga">Lisa Te Morenga</name><affiliation><mods:affiliation>Departments of Human Nutrition and Medicine, University of Otago, PO Box 56, Dunedin 9054, New Zealand</mods:affiliation></affiliation><affiliation><mods:affiliation>Riddet Institute, University of Otago</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: jim.mann@otago.ac.nz</mods:affiliation></affiliation></author><author><name sortKey="Mallard, Simonette" sort="Mallard, Simonette" uniqKey="Mallard S" first="Simonette" last="Mallard">Simonette Mallard</name><affiliation><mods:affiliation>Departments of Human Nutrition and Medicine, University of Otago, PO Box 56, Dunedin 9054, New Zealand</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: jim.mann@otago.ac.nz</mods:affiliation></affiliation></author><author><name sortKey="Mann, Jim" sort="Mann, Jim" uniqKey="Mann J" first="Jim" last="Mann">Jim Mann</name><affiliation><mods:affiliation>Departments of Human Nutrition and Medicine, University of Otago, PO Box 56, Dunedin 9054, New Zealand</mods:affiliation></affiliation><affiliation><mods:affiliation>Riddet Institute, University of Otago</mods:affiliation></affiliation><affiliation><mods:affiliation>Edgar National Centre for Diabetes and Obesity Research, University of Otago</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: jim.mann@otago.ac.nz</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: jim.mann@otago.ac.nz</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">BMJ : British Medical Journal</title><title level="j" type="abbrev">BMJ</title><idno type="eISSN">1756-1833</idno><imprint><publisher>British Medical Journal Publishing Group</publisher><date type="published" when="2013">2013</date><biblScope unit="volume">346</biblScope></imprint></series><idno type="istex">0D94718C6A5DDD6D1657DEC11B3C362CFAF22C52</idno><idno type="DOI">10.1136/bmj.e7492</idno><idno type="href">bmj-346-bmj-e7492.pdf</idno><idno type="ArticleID">morl006610</idno><idno type="local">bmj;346/jan15_3/e7492</idno></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">Objective To summarise evidence on the association between intake of dietary sugars and body weight in adults and children. Design Systematic review and meta-analysis of randomised controlled trials and prospective cohort studies. Data sources OVID Medline, Embase, PubMed, Cumulative Index to Nursing and Allied Health Literature, Scopus, and Web of Science (up to December 2011). Review methods Eligible studies reported the intake of total sugars, intake of a component of total sugars, or intake of sugar containing foods or beverages; and at least one measure of body fatness. Minimum duration was two weeks for trials and one year for cohort studies. Trials of weight loss or confounded by additional medical or lifestyle interventions were excluded. Study selection, assessment, validity, data extraction, and analysis were undertaken as specified by the Cochrane Collaboration and the GRADE working group. For trials, we pooled data for weight change using inverse variance models with random effects. We pooled cohort study data where possible to estimate effect sizes, expressed as odds ratios for risk of obesity or β coefficients for change in adiposity per unit of intake. Results 30 of 7895 trials and 38 of 9445 cohort studies were eligible. In trials of adults with ad libitum diets (that is, with no strict control of food intake), reduced intake of dietary sugars was associated with a decrease in body weight (0.80 kg, 95% confidence interval 0.39 to 1.21; P<0.001); increased sugars intake was associated with a comparable weight increase (0.75 kg, 0.30 to 1.19; P=0.001). Isoenergetic exchange of dietary sugars with other carbohydrates showed no change in body weight (0.04 kg, −0.04 to 0.13). Trials in children, which involved recommendations to reduce intake of sugar sweetened foods and beverages, had low participant compliance to dietary advice; these trials showed no overall change in body weight. However, in relation to intakes of sugar sweetened beverages after one year follow-up in prospective studies, the odds ratio for being overweight or obese increased was 1.55 (1.32 to 1.82) among groups with the highest intake compared with those with the lowest intake. Despite significant heterogeneity in one meta-analysis and potential bias in some trials, sensitivity analyses showed that the trends were consistent and associations remained after these studies were excluded. Conclusions Among free living people involving ad libitum diets, intake of free sugars or sugar sweetened beverages is a determinant of body weight. The change in body fatness that occurs with modifying intakes seems to be mediated via changes in energy intakes, since isoenergetic exchange of sugars with other carbohydrates was not associated with weight change.</div></front></TEI><istex><corpusName>bmj</corpusName><author><json:item><name>Lisa Te Morenga</name><affiliations><json:string>Departments of Human Nutrition and Medicine, University of Otago, PO Box 56, Dunedin 9054, New Zealand</json:string><json:string>Riddet Institute, University of Otago</json:string><json:string>E-mail: jim.mann@otago.ac.nz</json:string></affiliations></json:item><json:item><name>Simonette Mallard</name><affiliations><json:string>Departments of Human Nutrition and Medicine, University of Otago, PO Box 56, Dunedin 9054, New Zealand</json:string><json:string>E-mail: jim.mann@otago.ac.nz</json:string></affiliations></json:item><json:item><name>Jim Mann</name><affiliations><json:string>Departments of Human Nutrition and Medicine, University of Otago, PO Box 56, Dunedin 9054, New Zealand</json:string><json:string>Riddet Institute, University of Otago</json:string><json:string>Edgar National Centre for Diabetes and Obesity Research, University of Otago</json:string><json:string>E-mail: jim.mann@otago.ac.nz</json:string><json:string>E-mail: jim.mann@otago.ac.nz</json:string></affiliations></json:item></author><articleId><json:string>morl006610</json:string></articleId><language><json:string>eng</json:string></language><originalGenre><json:string>research-article</json:string></originalGenre><abstract>Objective To summarise evidence on the association between intake of dietary sugars and body weight in adults and children. Design Systematic review and meta-analysis of randomised controlled trials and prospective cohort studies. Data sources OVID Medline, Embase, PubMed, Cumulative Index to Nursing and Allied Health Literature, Scopus, and Web of Science (up to December 2011). Review methods Eligible studies reported the intake of total sugars, intake of a component of total sugars, or intake of sugar containing foods or beverages; and at least one measure of body fatness. Minimum duration was two weeks for trials and one year for cohort studies. Trials of weight loss or confounded by additional medical or lifestyle interventions were excluded. Study selection, assessment, validity, data extraction, and analysis were undertaken as specified by the Cochrane Collaboration and the GRADE working group. For trials, we pooled data for weight change using inverse variance models with random effects. We pooled cohort study data where possible to estimate effect sizes, expressed as odds ratios for risk of obesity or β coefficients for change in adiposity per unit of intake. Results 30 of 7895 trials and 38 of 9445 cohort studies were eligible. In trials of adults with ad libitum diets (that is, with no strict control of food intake), reduced intake of dietary sugars was associated with a decrease in body weight (0.80 kg, 95% confidence interval 0.39 to 1.21; P>0.001); increased sugars intake was associated with a comparable weight increase (0.75 kg, 0.30 to 1.19; P=0.001). Isoenergetic exchange of dietary sugars with other carbohydrates showed no change in body weight (0.04 kg, −0.04 to 0.13). Trials in children, which involved recommendations to reduce intake of sugar sweetened foods and beverages, had low participant compliance to dietary advice; these trials showed no overall change in body weight. However, in relation to intakes of sugar sweetened beverages after one year follow-up in prospective studies, the odds ratio for being overweight or obese increased was 1.55 (1.32 to 1.82) among groups with the highest intake compared with those with the lowest intake. Despite significant heterogeneity in one meta-analysis and potential bias in some trials, sensitivity analyses showed that the trends were consistent and associations remained after these studies were excluded. Conclusions Among free living people involving ad libitum diets, intake of free sugars or sugar sweetened beverages is a determinant of body weight. The change in body fatness that occurs with modifying intakes seems to be mediated via changes in energy intakes, since isoenergetic exchange of sugars with other carbohydrates was not associated with weight change.</abstract><qualityIndicators><score>8.5</score><pdfVersion>1.4</pdfVersion><pdfPageSize>595.276 x 841.89 pts (A4)</pdfPageSize><refBibsNative>false</refBibsNative><keywordCount>0</keywordCount><abstractCharCount>2773</abstractCharCount><pdfWordCount>14697</pdfWordCount><pdfCharCount>104515</pdfCharCount><pdfPageCount>25</pdfPageCount><abstractWordCount>426</abstractWordCount></qualityIndicators><title>Dietary sugars and body weight: systematic review and meta-analyses of randomised controlled trials and cohort studies</title><genre><json:string>research-article</json:string></genre><host><volume>346</volume><publisherId><json:string>bmj</json:string></publisherId><genre><json:string>journal</json:string></genre><language><json:string>unknown</json:string></language><eissn><json:string>1756-1833</json:string></eissn><title>BMJ : British Medical Journal</title></host><publicationDate>2013</publicationDate><copyrightDate>2013</copyrightDate><doi><json:string>10.1136/bmj.e7492</json:string></doi><id>0D94718C6A5DDD6D1657DEC11B3C362CFAF22C52</id><score>0.22030821</score><fulltext><json:item><original>true</original><mimetype>application/pdf</mimetype><extension>pdf</extension><uri>https://api.istex.fr/document/0D94718C6A5DDD6D1657DEC11B3C362CFAF22C52/fulltext/pdf</uri></json:item><json:item><original>false</original><mimetype>application/zip</mimetype><extension>zip</extension><uri>https://api.istex.fr/document/0D94718C6A5DDD6D1657DEC11B3C362CFAF22C52/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/0D94718C6A5DDD6D1657DEC11B3C362CFAF22C52/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a">Dietary sugars and body weight: systematic review and meta-analyses of randomised controlled trials and cohort studies</title><respStmt><resp>Références bibliographiques récupérées via GROBID</resp><name resp="ISTEX-API">ISTEX-API (INIST-CNRS)</name></respStmt></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>British Medical Journal Publishing Group</publisher><availability status="free"><p>Open Access</p></availability><date>2013</date></publicationStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a">Dietary sugars and body weight: systematic review and meta-analyses of randomised controlled trials and cohort studies</title><author xml:id="author-1"><persName><forename type="first">Lisa</forename><surname>Te Morenga</surname></persName><email>jim.mann@otago.ac.nz</email><note type="biography">research fellow</note><note type="correspondence"><p>Correspondence to: J Mann</p></note><affiliation>research fellow</affiliation><affiliation>Departments of Human Nutrition and Medicine, University of Otago, PO Box 56, Dunedin 9054, New Zealand</affiliation><affiliation>Riddet Institute, University of Otago</affiliation></author><author xml:id="author-2"><persName><forename type="first">Simonette</forename><surname>Mallard</surname></persName><email>jim.mann@otago.ac.nz</email><note type="biography">research assistant</note><note type="correspondence"><p>Correspondence to: J Mann</p></note><affiliation>research assistant</affiliation><affiliation>Departments of Human Nutrition and Medicine, University of Otago, PO Box 56, Dunedin 9054, New Zealand</affiliation></author><author xml:id="author-3" corresp="yes"><persName><forename type="first">Jim</forename><surname>Mann</surname></persName><email>jim.mann@otago.ac.nz</email><email>jim.mann@otago.ac.nz</email><note type="biography">professor</note><note type="correspondence"><p>Correspondence to: J Mann</p></note><affiliation>professor</affiliation><affiliation>Departments of Human Nutrition and Medicine, University of Otago, PO Box 56, Dunedin 9054, New Zealand</affiliation><affiliation>Riddet Institute, University of Otago</affiliation><affiliation>Edgar National Centre for Diabetes and Obesity Research, University of Otago</affiliation></author></analytic><monogr><title level="j">BMJ : British Medical Journal</title><title level="j" type="abbrev">BMJ</title><idno type="eISSN">1756-1833</idno><imprint><publisher>British Medical Journal Publishing Group</publisher><date type="published" when="2013"></date><biblScope unit="volume">346</biblScope></imprint></monogr><idno type="istex">0D94718C6A5DDD6D1657DEC11B3C362CFAF22C52</idno><idno type="DOI">10.1136/bmj.e7492</idno><idno type="href">bmj-346-bmj-e7492.pdf</idno><idno type="ArticleID">morl006610</idno><idno type="local">bmj;346/jan15_3/e7492</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2013</date></creation><langUsage><language ident="en">en</language></langUsage><abstract><p>Objective To summarise evidence on the association between intake of dietary sugars and body weight in adults and children. Design Systematic review and meta-analysis of randomised controlled trials and prospective cohort studies. Data sources OVID Medline, Embase, PubMed, Cumulative Index to Nursing and Allied Health Literature, Scopus, and Web of Science (up to December 2011). Review methods Eligible studies reported the intake of total sugars, intake of a component of total sugars, or intake of sugar containing foods or beverages; and at least one measure of body fatness. Minimum duration was two weeks for trials and one year for cohort studies. Trials of weight loss or confounded by additional medical or lifestyle interventions were excluded. Study selection, assessment, validity, data extraction, and analysis were undertaken as specified by the Cochrane Collaboration and the GRADE working group. For trials, we pooled data for weight change using inverse variance models with random effects. We pooled cohort study data where possible to estimate effect sizes, expressed as odds ratios for risk of obesity or β coefficients for change in adiposity per unit of intake. Results 30 of 7895 trials and 38 of 9445 cohort studies were eligible. In trials of adults with ad libitum diets (that is, with no strict control of food intake), reduced intake of dietary sugars was associated with a decrease in body weight (0.80 kg, 95% confidence interval 0.39 to 1.21; P<0.001); increased sugars intake was associated with a comparable weight increase (0.75 kg, 0.30 to 1.19; P=0.001). Isoenergetic exchange of dietary sugars with other carbohydrates showed no change in body weight (0.04 kg, −0.04 to 0.13). Trials in children, which involved recommendations to reduce intake of sugar sweetened foods and beverages, had low participant compliance to dietary advice; these trials showed no overall change in body weight. However, in relation to intakes of sugar sweetened beverages after one year follow-up in prospective studies, the odds ratio for being overweight or obese increased was 1.55 (1.32 to 1.82) among groups with the highest intake compared with those with the lowest intake. Despite significant heterogeneity in one meta-analysis and potential bias in some trials, sensitivity analyses showed that the trends were consistent and associations remained after these studies were excluded. Conclusions Among free living people involving ad libitum diets, intake of free sugars or sugar sweetened beverages is a determinant of body weight. The change in body fatness that occurs with modifying intakes seems to be mediated via changes in energy intakes, since isoenergetic exchange of sugars with other carbohydrates was not associated with weight change.</p></abstract></profileDesc><revisionDesc><change when="2013">Published</change><change xml:id="refBibs-istex" who="#ISTEX-API" when="2016-10-4">References added</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/0D94718C6A5DDD6D1657DEC11B3C362CFAF22C52/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="corpus bmj" wicri:toSee="no header"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="no"</istex:xmlDeclaration><istex:docType PUBLIC="-//NLM//DTD Journal Archiving and Interchange DTD v2.3 20070202//EN" URI="archivearticle.dtd" name="istex:docType"></istex:docType><istex:document><article article-type="research-article"><front><journal-meta><journal-id journal-id-type="hwp">bmj</journal-id><journal-id journal-id-type="nlm-ta">BMJ</journal-id><journal-id journal-id-type="publisher-id">bmj</journal-id><journal-title>BMJ : British Medical Journal</journal-title><issn pub-type="epub">1756-1833</issn><publisher><publisher-name>British Medical Journal Publishing Group</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">morl006610</article-id><article-id pub-id-type="doi">10.1136/bmj.e7492</article-id><article-id pub-id-type="other">bmj;346/jan15_3/e7492</article-id><article-id pub-id-type="other">bmj;bmj.e7492</article-id><article-id pub-id-type="other">jan15_3</article-id><article-id pub-id-type="other">bmj.e7492</article-id><article-id pub-id-type="other">bmj.e7492</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research</subject></subj-group></article-categories><title-group><article-title>Dietary sugars and body weight: systematic review and meta-analyses of randomised controlled trials and cohort studies</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="no"><name><surname>Te Morenga</surname><given-names>Lisa</given-names></name><role>research fellow</role><xref ref-type="aff" rid="aff1">1</xref><xref ref-type="aff" rid="aff2">2</xref></contrib><contrib contrib-type="author" corresp="no"><name><surname>Mallard</surname><given-names>Simonette</given-names></name><role>research assistant</role><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author" corresp="yes"><name><surname>Mann</surname><given-names>Jim</given-names></name><role>professor</role><xref ref-type="aff" rid="aff1">1</xref><xref ref-type="aff" rid="aff2">2</xref><xref ref-type="aff" rid="aff3">3</xref></contrib><aff id="aff1"><label>1</label>Departments of Human Nutrition and Medicine, University of Otago, PO Box 56, Dunedin 9054, New Zealand </aff><aff id="aff2"><label>2</label>Riddet Institute, University of Otago</aff><aff id="aff3"><label>3</label>Edgar National Centre for Diabetes and Obesity Research, University of Otago</aff></contrib-group><author-notes><corresp>Correspondence to: J Mann <email>jim.mann@otago.ac.nz</email></corresp></author-notes><pub-date pub-type="collection"><year>2013</year></pub-date><pub-date pub-type="epub-original"><year>2013</year></pub-date><volume>346</volume><volume-id pub-id-type="other">346</volume-id><volume-id pub-id-type="other">346</volume-id><elocation-id>e7492</elocation-id><history><date date-type="accepted"><day>28</day><month>October</month><year>2012</year></date></history><permissions><copyright-statement>© Te Morenga et al 2012</copyright-statement><copyright-year>2012</copyright-year><copyright-holder>Te Morenga et al</copyright-holder><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/"><p>This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: <ext-link xlink:href="http://creativecommons.org/licenses/by-nc/2.0/" ext-link-type="uri">http://creativecommons.org/licenses/by-nc/2.0/</ext-link> and <ext-link xlink:href="http://creativecommons.org/licenses/by-nc/2.0/legalcode" ext-link-type="uri">http://creativecommons.org/licenses/by-nc/2.0/legalcode</ext-link>.</p></license></permissions><self-uri content-type="pdf" xlink:role="full-text" xlink:href="bmj-346-bmj-e7492.pdf"></self-uri><abstract><p><bold>Objective</bold> To summarise evidence on the association between intake of dietary sugars and body weight in adults and children.</p><p><bold>Design</bold> Systematic review and meta-analysis of randomised controlled trials and prospective cohort studies.</p><p><bold>Data sources</bold> OVID Medline, Embase, PubMed, Cumulative Index to Nursing and Allied Health Literature, Scopus, and Web of Science (up to December 2011).</p><p><bold>Review methods</bold> Eligible studies reported the intake of total sugars, intake of a component of total sugars, or intake of sugar containing foods or beverages; and at least one measure of body fatness. Minimum duration was two weeks for trials and one year for cohort studies. Trials of weight loss or confounded by additional medical or lifestyle interventions were excluded. Study selection, assessment, validity, data extraction, and analysis were undertaken as specified by the Cochrane Collaboration and the GRADE working group. For trials, we pooled data for weight change using inverse variance models with random effects. We pooled cohort study data where possible to estimate effect sizes, expressed as odds ratios for risk of obesity or β coefficients for change in adiposity per unit of intake. </p><p><bold>Results</bold> 30 of 7895 trials and 38 of 9445 cohort studies were eligible. In trials of adults with ad libitum diets (that is, with no strict control of food intake), reduced intake of dietary sugars was associated with a decrease in body weight (0.80 kg, 95% confidence interval 0.39 to 1.21; P<0.001); increased sugars intake was associated with a comparable weight increase (0.75 kg, 0.30 to 1.19; P=0.001). Isoenergetic exchange of dietary sugars with other carbohydrates showed no change in body weight (0.04 kg, −0.04 to 0.13). Trials in children, which involved recommendations to reduce intake of sugar sweetened foods and beverages, had low participant compliance to dietary advice; these trials showed no overall change in body weight. However, in relation to intakes of sugar sweetened beverages after one year follow-up in prospective studies, the odds ratio for being overweight or obese increased was 1.55 (1.32 to 1.82) among groups with the highest intake compared with those with the lowest intake. Despite significant heterogeneity in one meta-analysis and potential bias in some trials, sensitivity analyses showed that the trends were consistent and associations remained after these studies were excluded.</p><p><bold>Conclusions</bold> Among free living people involving ad libitum diets, intake of free sugars or sugar sweetened beverages is a determinant of body weight. The change in body fatness that occurs with modifying intakes seems to be mediated via changes in energy intakes, since isoenergetic exchange of sugars with other carbohydrates was not associated with weight change.</p></abstract></article-meta></front></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo><title>Dietary sugars and body weight: systematic review and meta-analyses of randomised controlled trials and cohort studies</title></titleInfo><titleInfo type="alternative" contentType="CDATA"><title>Dietary sugars and body weight: systematic review and meta-analyses of randomised controlled trials and cohort studies</title></titleInfo><name type="personal"><namePart type="given">Lisa</namePart><namePart type="family">Te Morenga</namePart><affiliation>Departments of Human Nutrition and Medicine, University of Otago, PO Box 56, Dunedin 9054, New Zealand</affiliation><affiliation>Riddet Institute, University of Otago</affiliation><affiliation>E-mail: jim.mann@otago.ac.nz</affiliation><description>Correspondence to: J Mann</description><description>research fellow</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Simonette</namePart><namePart type="family">Mallard</namePart><affiliation>Departments of Human Nutrition and Medicine, University of Otago, PO Box 56, Dunedin 9054, New Zealand</affiliation><affiliation>E-mail: jim.mann@otago.ac.nz</affiliation><description>Correspondence to: J Mann</description><description>research assistant</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal" displayLabel="corresp"><namePart type="given">Jim</namePart><namePart type="family">Mann</namePart><affiliation>Departments of Human Nutrition and Medicine, University of Otago, PO Box 56, Dunedin 9054, New Zealand</affiliation><affiliation>Riddet Institute, University of Otago</affiliation><affiliation>Edgar National Centre for Diabetes and Obesity Research, University of Otago</affiliation><affiliation>E-mail: jim.mann@otago.ac.nz</affiliation><affiliation>E-mail: jim.mann@otago.ac.nz</affiliation><description>Correspondence to: J Mann</description><description>professor</description><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="research-article"></genre><originInfo><publisher>British Medical Journal Publishing Group</publisher><dateIssued encoding="w3cdtf">2013</dateIssued><copyrightDate encoding="w3cdtf">2013</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract>Objective To summarise evidence on the association between intake of dietary sugars and body weight in adults and children. Design Systematic review and meta-analysis of randomised controlled trials and prospective cohort studies. Data sources OVID Medline, Embase, PubMed, Cumulative Index to Nursing and Allied Health Literature, Scopus, and Web of Science (up to December 2011). Review methods Eligible studies reported the intake of total sugars, intake of a component of total sugars, or intake of sugar containing foods or beverages; and at least one measure of body fatness. Minimum duration was two weeks for trials and one year for cohort studies. Trials of weight loss or confounded by additional medical or lifestyle interventions were excluded. Study selection, assessment, validity, data extraction, and analysis were undertaken as specified by the Cochrane Collaboration and the GRADE working group. For trials, we pooled data for weight change using inverse variance models with random effects. We pooled cohort study data where possible to estimate effect sizes, expressed as odds ratios for risk of obesity or β coefficients for change in adiposity per unit of intake. Results 30 of 7895 trials and 38 of 9445 cohort studies were eligible. In trials of adults with ad libitum diets (that is, with no strict control of food intake), reduced intake of dietary sugars was associated with a decrease in body weight (0.80 kg, 95% confidence interval 0.39 to 1.21; P<0.001); increased sugars intake was associated with a comparable weight increase (0.75 kg, 0.30 to 1.19; P=0.001). Isoenergetic exchange of dietary sugars with other carbohydrates showed no change in body weight (0.04 kg, −0.04 to 0.13). Trials in children, which involved recommendations to reduce intake of sugar sweetened foods and beverages, had low participant compliance to dietary advice; these trials showed no overall change in body weight. However, in relation to intakes of sugar sweetened beverages after one year follow-up in prospective studies, the odds ratio for being overweight or obese increased was 1.55 (1.32 to 1.82) among groups with the highest intake compared with those with the lowest intake. Despite significant heterogeneity in one meta-analysis and potential bias in some trials, sensitivity analyses showed that the trends were consistent and associations remained after these studies were excluded. Conclusions Among free living people involving ad libitum diets, intake of free sugars or sugar sweetened beverages is a determinant of body weight. The change in body fatness that occurs with modifying intakes seems to be mediated via changes in energy intakes, since isoenergetic exchange of sugars with other carbohydrates was not associated with weight change.</abstract><relatedItem type="host"><titleInfo><title>BMJ : British Medical Journal</title></titleInfo><titleInfo type="abbreviated"><title>BMJ</title></titleInfo><genre type="journal">journal</genre><identifier type="eISSN">1756-1833</identifier><identifier type="PublisherID">bmj</identifier><identifier type="PublisherID-hwp">bmj</identifier><identifier type="PublisherID-nlm-ta">BMJ</identifier><part><date>2013</date><detail type="volume"><caption>vol.</caption><number>346</number></detail></part></relatedItem><identifier type="istex">0D94718C6A5DDD6D1657DEC11B3C362CFAF22C52</identifier><identifier type="DOI">10.1136/bmj.e7492</identifier><identifier type="href">bmj-346-bmj-e7492.pdf</identifier><identifier type="ArticleID">morl006610</identifier><identifier type="local">bmj;346/jan15_3/e7492</identifier><accessCondition type="use and reproduction" contentType="open-access">This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.</accessCondition><recordInfo><recordContentSource>BMJ</recordContentSource><recordOrigin>Te Morenga et al</recordOrigin></recordInfo></mods></metadata><annexes><json:item><original>true</original><mimetype>image/jpeg</mimetype><extension>jpeg</extension><uri>https://api.istex.fr/document/0D94718C6A5DDD6D1657DEC11B3C362CFAF22C52/annexes/jpeg</uri></json:item></annexes><enrichments><json:item><type>refBibs</type><uri>https://api.istex.fr/document/0D94718C6A5DDD6D1657DEC11B3C362CFAF22C52/enrichments/refBibs</uri></json:item></enrichments><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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